Saving Grace
by lotrspnfangirl
Summary: Sam has been in a mental institution for most of his life and has accepted the fact that he would never be out, would never be normal. When a new psychiatrist takes over his case, he begins asking different questions and Sam starts to think that maybe, just maybe, he can be saved.
1. Chapter 1

**Title:** Saving Grace (1/?)  
 **Rating:** NC-17  
 **Pairing:** Sam/Castiel  
 **Summary:** Sam has been in a mental instition for most of his life and has accepted the fact that he would never be out, would never be normal. When a new psychaitrist takes over his case, he begins asking different questions and Sam starts to think that maybe, just maybe, he can be saved.  
 **Warnings:** Angst. Suicide attempts. Self mutilation. Character Death (Winchesters). Angst. Angst. Oh, angst.  
 **A/N:** Based off the prompt by **emmatheslayer** and written for her! I own nothing, except the fiction. Huge thanks to my bestie **keywielder** for listening to me whine bounce ideas off of at three in the morning and for her constant input. Also to **elwarre** for betaing this for me! Any remaining mistakes are my own.  
 **Prompt:** Sam is in a mental hospital and Castiel is psychiatrist that sees how good and sweet he can be when he is in his right mind but Sam can never understand why he is drawn to Castiel and sticks close to him hoping he gets better.

Blood. Hot and sticky, congealing in large pools across the floor. There was always so much blood.

Sam spun around, his eyes darting wildly across the room. He could still feel the presence, the monster lurking in the shadows. He held his breath, hoping the beating of his heart echoing in his head was there, and there alone. He took a step back, pressing himself against the wall.

 _He_ was still there.

A floorboard in the hallway creaked and Sam felt his heart stop. He squeezed his eyes shut and bit down hard on his tongue, the coppery taste flooding his already bloodied senses. He heard the squish of something moving through the soaked carpet; he could feel the heat radiating from the manifestation before him.

His eyes flew open along with his mouth in a silent scream.

He knew he was doomed.

"I need some IM Haldol in here!" Sam bucked against the set of hands pushing him down. The metallic tang of blood was still in his mouth and he gasped wildly for air, fighting to breathe.

"No! No!" He screamed, clawing at the set of hands holding him down. "It was him! It was the monster!"

"Son of a bitch!" The voice belonging to the hands hissed, ripping one of his hands back. "Sam! You need to calm down! I need some help in here!"

"No! I need to go!"

"Five?" A second voice joined the room and Sam looked up at the new face in desperation.

"He's going to come back, please! You have to listen to me!" He pleaded, gripping the wrists that were back against his chest, pulling at the sleeve of his night shirt.

"Make it ten, Ally. He fucking drew blood again."

"Sam? Hi, Sam…" The woman was coming closer, eyes darting back and forth between the glass vial and syringe in her hand to his face. She smiled kindly, and he knew it was useless.

She didn't care. She didn't _believe_ him. They would never be able to save him.

"No, no please." He felt the tears streaming down his cheeks, hot and wet as they dropped down to pool in the hollow of his neck. Pooling, like the blood. "Please… Mom… Dean…"

He felt the pinch in his arm and the woman was speaking to him softly, rubbing her fingers through his hair. The other set of hands withdrew, taking the rest of his fight with them.

He was truly doomed.

...

"Good morning!" He blinked his eyes a few times; his arms and his head felt like they weighed a million pounds. "Remember me? I'm Charlie. I'm going to be your nurse today." She turned to face him, her red hair spilling over her shoulders and clashing with the lime green scrubs she was wearing today.

"Charlie." He croaked out, nodding his head. "You were here yesterday." She smiled at him and moved to the side of his bed, pulling a dry-erase marker from her pocket and wiping off the night shift's notes, adding her name.

"Are you in any pain this morning?" She asked, walking back around the bed and pulling the med cart into the room. "I heard you had… a difficult night again. Can you tell me your name and date of birth?"

"My head… feels fuzzy. But I'm not in pain. Sam Winchester, May 2nd, 1983." He said after a moment, watching as she clicked away at the keyboard, nodding her head as he spoke. From outside the room he could hear the rumbling of the food cart coming down the hallway. His stomach grumbled in anticipation.

"Okay, I have your Protonic, Ativan, Zoloft, Lithium and two Tylenol. We finished your antibiotic last night." She paused between each medication, giving him time to ask what each one was for. As if he didn't know. As if he hadn't been forced to take them for the majority of his life. As if they were suddenly different….

He nodded, and it was taken as an acceptable response. She dumped all of the pills into the small metal well so she could crush them completely.

He smirked. He had managed to get away with slipping whole pills under his tongue for almost the entirety of last year. Seeing them crushed into a fine powder to ensure they were taken and digested made him swell with pride. And feel a bit sick.

"Alright, Sam." She handed him a small cup, the applesauce in it tinted a strange blue color from the pills, and then a plastic spoon. She waited until he scraped the cup clean, handing back the plastics before shutting the drawers on her cart and pushing it back out of the door. "Get dressed. Breakfast will be in twenty minutes. And Sam? Make sure you clean your nails."

He looked down as the door was shut. His fingernails were caked in dark blood, thick strips of flesh dried underneath the nails. He flicked a piece out, watching where it landed on the floor and bit back the hope the same nurse wouldn't be on duty tonight. He laughed bitterly, the sound splitting the new silence of the room. He would never be that lucky.

He slipped his legs off of the bed, taking care to pull the comforter up and attempting to smooth it out. He would get points for having a "well-kept living space". As if _normal_ people actually made their beds every day.

Sam supposed he should consider himself lucky: as a ward of the state, the taxpayers were fitting this lovely bill of him living in style. Most of the other state-paid residents were kept in double rooms, scattered through to the end of the hallway. Sam, however, was given the first room on the floor, straight across from the nurse's station, and would never have to share his room with anyone else. He did miss having his own shower stall in his room… but that would never be something he would have again.

Besides the bed, the only other furniture in the room was a large plastic chair and a small plastic cabinet. He slipped off his boxers, and opened the top drawer to pull out a clean pair and a fresh set of white hospital scrubs; the only clothing he had, again thanks to being a ward. White. Everything was white.

Because white was pure. And if he was surrounded by it, it would cure him.

He shoved himself into the clothes and tossed the dirty set on top of the cabinet. He eyed the tennis shoes sitting under the base of his bed, zip ties replacing the shoe laces that were supposed to be there. He thought about slipping them on, rubbing it in their faces that as much as the staff thought so? They weren't perfect either. He opted for socks instead.

"Where's Charlie?" He asked as he slipped out of his room. Behind the desk a young blonde woman looked up from the computer screen, eyeing him carefully. Great. New secretary. He fought not to throw his hands up and scream 'boo'; the fear in her eyes told him all he needed to know.

"She's seeing patients. Can I help you, Mr. Winchester?" She asked, eyes darting to the computer screen again, no doubt checking to make sure she had the right name.

"I went out yesterday. They forgot to take my shoes out of my room."

"I will let her know." The girl smiled at him carefully. "Thank you for telling us, Samuel."

"Just Sam." He replied, turning away from her and starting down the hallway.

Morning was his favorite part of the day. Although he wasn't a fan of being woken up and having pills shoved down his throat, he enjoyed the scent of coffee that met him in the hallway, and the smell of hot plastic from the food cart was oddly comforting. He made his way to the cart, glancing down at the trays quickly until he saw his own.

"Morning, Sammy." Bobby said as he walked up behind him. The older man had always been friendly to him, and never minded when he took initiative to get his own food at mealtimes. "I added some extra sugar packets and creamer to your tray." He winked at Sam and clapped him on the shoulder to let him pass.

"Thanks, Bobby." Sam was grateful and went for them immediately. He ripped open the sugars first, dumping them into the hot cup and crumpling up the wrappers. He didn't need anyone getting on him about how much sugar he was taking in and wondering if that was the reason he was up all night.

That would be a much better reason. He would ingest _only_ sugar packets, if that were the case.

"You were screaming out for Dean again." A tray slammed down across from him and Sam felt his stomach twist in a knot.

"Fuck off, Az." He whispered, refusing to look away from his plate. The man across from him laughed, the sound sending shivers straight down his spine.

"Dean. Dean, save me. I mean come on, Sam. That's not how you convince them you're not totally bonkers. If I were you, I'd be screaming out Charlie's name. I would totally bone that nurse."

"Fuck. Off." He repeated, his hands shaking as they gripped the end of the tray.

"Oh, come on, Sammy," Az purred, and Sam snapped.

"I told you not to fucking call me that!" He could feel his entire body shaking, and his eyes darted up to meet bloodshot yellow ones. He knew from group that it was a condition from the alcohol Az used to drown himself in. A smile crept across Az's entire face, eyes dancing as they took in Sam's stance. This man was a demon. Sam reached forward, hand twisting in the front of Az's shirt and yanking him up, hard. Their knees hit the table top, sending their breakfast plates clattering onto the floor.

"Sam!" Bobby was yelling behind him, tossing the tray he was carrying on a table nearby and grabbing onto Sam's arm. "Sam, let him go."

"Yeah, _Sammy._ Let me go."

Sam shook. His shaking shook Az, shook Bobby. Bobby was still yelling, Az was still laughing when he felt a pinch in his neck. He was still laughing as Sam's fingers loosened and he slipped back into a sitting position. He was still laughing when Sam was loaded into a wheelchair and carted away. Sam could still hear him laughing.

...

"Come in," a rough voice called out when Charlie knocked on the door, and she nudged him forward with a smile. Probably glad to get rid of him. Sam sighed, pushing open the door. "Sam Winchester?"

He fought back the grimace as he took in the man sitting behind the large desk in the center of the room. He had dark hair, piercing blue eyes, and he was the third therapist he had seen this week.

"One and only," Sam muttered, hearing Charlie close the door behind him. He waited for direction.

"Please." The man stood up, adjusting his tie as he nodded to an oversized plush chair. Sam eyed it for a moment before taking the offer. It would be much more comfortable than the plastic chairs he was used to. "I'm Dr. Novak." He walked around his desk and met Sam with a shake of his hand. "You can feel free to call me Dr. N or Cas, if that makes you more comfortable."

"What does it matter?" Sam shrugged, relaxing into the cushion. "You'll see me for two sessions and then decide I'm too difficult for you. Then I'll be shuffled through the doctors here until a new one comes to take a bat at it."

Dr. Novak nodded carefully, listening to every word that Sam said. They all did, every single word he uttered. Until they decided he was crazy.

"Well, I like a challenge." He smiled. Instead of taking his position back behind the desk, the man pulled up a chair to sit before Sam, leaning carefully back against it.

"Where's your notepad? Your tape recorder? Your desk as a safety blanket in case I snap and get violent?" Sam spat out, suddenly feeling extremely uncomfortable. Without missing a beat, Dr. Novak smiled and leaned forward.

"I thought we would use this session to get to know one another. And do you feel like you're going to be violent, Sam?" The doctor leaned forward to grab a pillow from beside him, and Sam stiffened as his thigh was brushed. He crossed his arm over it, holding it against his chest. "Security pillow," he said in explanation.

Sam stared. In the ten years he had been living here, he had seen a total of forty different psychologists and six specialists, and not one of them had ever made him feel this way. He ran a hand through his hair, suddenly nervous.

"Yeah. Okay."

"So Sam… I was reading through your notes from other sessions… I'm going to let you know what they say, okay?" Sam nodded, rolling his eyes. "17 year old male who presents with paranoid schizophrenia, developing before adolescence. Patient suffers from extreme paranoid delusions, often suffering periods of catatonic behavior. Patient experiences positive symptoms including hallucinations and impulses that result in disorganized behavior and psychotic episodes.

"Your treatment plan for the better part of the last decade was to work on active listening and agitation triggers to better acclimate into everyday life and society. There have been more relapses in treatments that successes. How am I doing so far?"

"Looks like you've got it all memorized. You left out that the paranoid delusions usually result in night terrors, causing the patient to sink into avolition and miss vital opportunities for successful involvement with treatment course." Sam said, raising his voice slightly in a mocking tone. "I've heard it all before."

"Sounds like it." The doctor smiled again. Sam hated him.

"So, are you going to change my meds? Try a new treatment? Maybe electroconvulsive therapy again?"

"What do you think about what your chart says, Sam? I can call you Sam, right?"

Sam blinked at him, then nodded. "Everyone else does."

"Okay, Sam. So? What do you think about it?"

"Well, that I'm crazy obviously. I have more than a few goddamn screws loose and I am a complete danger to myself and to society. Treatments haven't worked, I've relapsed because I am an incurable psychotic freak." He was surprised to feel the hot sting of tears behind his eyes, the knot sliding up in his throat. "We would all be so much better if I wasn't here."

"Is that why you tried to kill yourself?" Sam swallowed the knot, his left hand immediately covering the thick, red scar on his right forearm. He refused to answer. He didn't want to go down that road, not again.

"What type of changes are you going to make." He asked after a moment, the silence in the room suffocating.

"None." Sam's eyes shot up, and he studied the Doctors face. "Not yet anyways. I don't _know_ you, Sam. We will keep you on your current medications, and we will continue to have sessions three times a week unless you feel like you need more. I am glad to read my colleagues interpretations, but they're not _mine_. I think it would be highly unprofessional to assume that their interpretations of your symptoms were the same I would make, don't you?"

He didn't wait for Sam to reply.

"The art of mental health is fascinating, Sam. And complicated. It is definitely not a perfect science. We would not be here if it was. And it's unfortunate… You know firsthand how unfortunate that is. You've spent ten years of your life here, and as your doctor and a professional who is dedicated to helping my patients, I owe it to you to start from a clean slate. Everything is open to interpretation and there are new studies and treatments popping up every single day. We need to embrace that opportunity. Does that sound like a plan?"

Sam blinked a few times, trying to process the Doctor's words, guess at the hidden ultimatum.

"I think you're just as crazy as I am." Sam said after a moment, crossing his arms across his chest and eyeing him carefully.

"Sam." The doctor laughed. "Let's stray away from that word, shall we? I don't think you're crazy. The definition of crazy is also up to interpretation. Just because your mind works differently, doesn't mean it's wrong. We live in a society that is not completely accepting of people who have mental incapacities, our mental health alliance is extremely lacking…"

"Right." What he really wanted to say was _'what the fuck?'_

"Well, do you have any questions for me, Sam?"

"Are you going to analyze everything I ask you?"

"Probably." Novak cocked his head, thinking. "I'm hardwired that way."

"Then, no." He was given a smile as a response.

"Have you ever written in a journal, Sam?"

"You already know the answer to that, Dr. Novak." Sam snorted, eyes darting to the clock on the wall.

"I meant a journal for you. I think that sometimes writing down ones thoughts can be a form of self-expression and therapeutic. Forcing you to write in something that is supposed to be an extremely personal part of yourself and then share it, is not a productive way to get truth written on a page. It enables you to lie, to yourself as well as those who will read your thoughts."

"I don't need a diary."

"Okay."

"Okay."

They sat in silence. The doctor seemed completely comfortable in his presence. Sam found himself picking at the bottom of his shirt, then froze, eyes darting back up to see Novak watching him. He let his hands fall still, wondering briefly what could be interpreted from picking at one's clothing.

 _Restless. Impatient. Intolerant. Noncompliant. Destructive. Dangerous._

"I think we made a good start today, Sam. I look forward to seeing you on Wednesday. I think for tonight and tomorrow, you should consider getting your thoughts down on paper, even if you destroy it afterwards, before you to go sleep."

"Sure." Sam said, nodding his head, relief washing over him that he was free to go.

"And Sam?" Sam froze, his hand on the door knob. Dr. Novak had stood again and was replacing the pillow in the chair, smoothing the fabric carefully with his fingers. "Clean slate. Okay?"

...

Sam's heart was beating wildly, jolting him out of his sleep. He could hear his breath, panting in the darkness. He inhaled, holding his breath, trying to calm himself.

He pushed himself up against the headboard, looking around the room.

Considering he was in the hospital, it was strangely quiet.

His heartbeat increased, fluttering against his ribcage, causing his stomach to churn.

"No," he whispered, fighting not to squeeze his eyes shut. "Go away." His eyes darted to the corner of the room, the inky darkness untouched by the light filtering in from the hallway.  
He didn't need to see him. He could _hear_ him. His breathing was slow, deep inhalations through sharp teeth. There was a faint gurgling sound and Sam knew what it was.

If he could see him, he would see the blood tainting his lips, dripping down his chin, spilling onto the floor.

"No, please," he whispered, tears falling from his eyes as he pushed himself into the corner of the bed and the wall. They sat there in silence, their breaths battling with each other, both waiting for the other to make the first move.

Sam waited until the morning light chased away his demons. He let his eyes fall closed, the early morning sun hitting his face. He allowed himself to relax in its faux embrace, let himself believe for a moment he was safe.

Even the brightest light couldn't ebb out his darkness.

...

Sam hated a lot of things.

He hated the dreams that plagued him, causing him to wake up screaming in the middle of the night. He hated the pills and the shots that made him _different_. He hated being forced to talk in a group, acting as if he _cared_ that Bulimic-Megan was eating most of her meals, that Annie-Anxious was able to go to a store without a panic-induced freak out, that Joe-Shmoe-Who-Really-Should-Be-At-Alcoholics-Anonymous was 15 days sober. Because Sam didn't care. They were just more stories, names and faces to add to the jumble inside of his head, more people to think about and to worry about.

But more than that? Sam hated himself.

"You're quiet today." The doctor, _Cas_ , mused from his spot on the couch. His legs were crossed at the ankles, tucked underneath the couch, and Sam couldn't stop his staring at the long, knotted laces he found there. A sign of normalcy.

Today, Sam hated him most of all.

"I have nothing to say." He sighed, tearing his eyes away from the laces, eyes flicking to the clock on the far wall.

"Am I boring you?"

"It's not like I have anything better to do," Sam replied, sighing again.

"What do you want to talk about?" Cas shifted forward, his blue eyes searching until they met Sam's own.

"You're the psychiatrist. You tell me," Sam spat, shrinking back away from the gaze. He swallowed hard, wondering what exactly it was that those eyes were seeing. Did they see how truly screwed up he was? Could he see the blood that Sam saw, everywhere he went? Could he see how terrified Sam was, the threat of him coming back, looming over Sam, no matter where he went?

"Are you telling me I can choose?" Cas cocked his head, adjusting his tie. Sam hated that too. The questions, always fucking questions. When he didn't respond, Cas pressed on. "Let's talk about your family."

"I'm a ward of the state."

"Let's talk about your family, _before_." Sam felt his blood freeze, right there in his veins. He felt his body start to shake, shivering and fighting against the chill. If he could warm up, melt the bloodied icicles scratching their way to his heart, he would be okay. He felt his eyes darkening, the ice spreading, suffocating, killing.  
 _  
"Sammy, you need to go." Sam shook his head, fingers scrabbling to grip at the back of Dean's shirt. "Sam! Now!" Dean hissed, ripping himself out of the grasp, pushing Sam down hard. Sam landed on the floor, a sharp gasp escaping his lungs as he landed with a thud. He looked up, Dean's bright green eyes flashing in apology. His brother, always strong and smart, stood there with his lower lip trembling, eyes pleading._

Sam nodded, pushing with his legs to scramble backwards across the floor. Relief passed over Dean's face, and Sam wanted to vomit.

"Don't come out until I come and get you, Sammy. I'll come for you." Sam nodded, finally pushing to his feet. Dean would come for him, Sam knew that. He met Dean's eyes again, and they spoke of an age far greater than the eleven years they'd been around.

"Promise," Sam whispered and turned to fly into the night.

"Sam? Sam!" Sam blinked, his vision still foggy. A warm hand was on his shoulder, pushing him down, heat radiating down through his chest, melting the ice. "Are you with me?"

Sam swallowed hard, looking around the room. He scanned over the dark cherry wood desk, a stark contrast to the pale yellow walls around it. The carpet was a dull tan color, faint stains that had failed to scrub out completely were splattered around. Concerned blue eyes, hidden by a spill of dark brown hair, swarmed into focus.

"Sam?"

"I need to go lay down," Sam whispered, his stomach churning. He could feel his eyes widen, his finger clenching down on the fabric of the chair, like they had to the back of Dean's shirt. He gasped, lungs fighting to take in as much oxygen as they could. "I need to… I'm going…"

"Sam." Cas' voice was soft, firm; it grounded him. He blinked again, shaking his head.

"Please," he whispered, not knowing what he was asking, _why_ he was asking.

"We can just sit here in silence, let you catch your breath." Sam nodded, watching as Cas moved away from him, knees creaking as he pushed himself to a standing position. He returned to his spot on the couch, picking up his notepad, twisting a pen between his fingers.

Sam waited, waited for Cas to start scribbling away. Adding notes and suggestions and treatments to his filled-to-the-brim chart. He waited for Cas to start prodding, asking him to explain, to talk, to remember. Ask him to forget, to practice finding an anchor to reality, to normalcy. He waited.

Like he had waited for Dean. Sitting with his knees pulled up into his chest, the cold from the earth seeking into the seat of his jeans. Waiting until the sun filtered in through the cracks in the wood. And like with Dean, Sam was left waiting.


	2. Chapter 2

"Good Morning, Sam!" Charlie sing-songed, tugging on the blinds to allow the dim morning light to shine into the room.

"Morning, Charlie," Sam muttered back, yanking the thin, scratchy blanket over his head.

"Come on, Sam… Up!" She said, tugging on it gently, smiling when she met his eyes. "You have to get up for breakfast."

Sam wasn't hungry, but knew better than to say so. Instead, he nodded, recited his birthday and took the medications handed to him like a good boy. Charlie patted his shoulder on her way out the door and Sam couldn't tell if she was just being friendly, or offering him pity…

Sam made his way down the hallway, offering a small smile to Bobby as he accepted the tray that was handed to him. Az was sitting in the center of the room, his eyes watching Sam's every movement, a smirk tugging at his lips. Sam bit his lower lip, forcing himself to turn around again.

Since the 'incident', Az had convinced most of the staff that Sam had been the instigator and had been hallucinating. Of course, take the manic depressive's word over the schizo. He moved his way around the tables into the small side room reserved for the 'special' patients.

"Morning Sam." A young nurse's aide smiled at him from her spot at the end of the room. He couldn't remember her name for the life of him. It didn't matter… Aides, and usually nurses too, didn't last here very long. He had been a resident here even longer than any of the current staff.

"Morning," he muttered, dropping his tray on the first table and slipping into the chair. The sound made Becky, the only other patient in 'Nutrition Group', jump.

"No, no, no!" She screamed, eyes darting around the room wildly. Sam jumped at her outburst, watching her carefully. "They're here! I heard them!" She screamed, picking up the butter knife from her tray and wielding it as a weapon.

Sam snorted. Whatever demons she was seeing, he highly doubted a butter knife would save her.

"Becky, you're okay." The aide was on her feet, offering a comforting hand to Becky's shoulder, trying to pull her back. Trying, and failing.

"No! You're with them! I know you are!" Becky screamed, shoving back away from the table and toppling the chair with her in it, to the floor. She was bucking against the ground, legs caught on the table and leg of the chair. She was screaming now, words turning into a blood curdling howl.

"Sam? I think you're okay." The nurse caught his attention and smiled at him, expression guarded. "You can join the others again." Her eyes darted between her two patients and like a punch to the gut, Sam realized she thought Becky's outburst would make him start acting crazy too.

He snorted, leaving his plate behind and slipping out of the room.

Hopefully with all of the commotion, they wouldn't notice he hadn't eaten.

Hopefully.

...

"I need you to tell them that I'm fine." Sam threw himself into the arm chair, dangling a leg over the side. Behind him he heard the heavy door snap shut.

"Hello to you too, Sam," Doctor Novak snorted, slipping off his glasses and setting them against his desk.

"Yeah, hi." Sam sighed. "So, can you tell them I'm better and they can give me a goddamn razor? I look like I'm fucking 30."

The Doctor chuckled and it made Sam's blood boil.

"Well, are you fine?" He asked, pushing away from his desk and walking around it slowly to lean against the end. "I mean, really? It's only been twenty days since you decided to take a blade to your wrists."

"Yeah, well… It was a mistake, and I love my life, and I will never do it again. I don't want to hurt myself, I just want to shave _myself_ and not have to ask a nurse to do it." Sam exhaled his reply in one breath, forcing his expression to one of complete innocence. "Please?"

"Sam." Doctor Novak smiled, crossing his arms across his chest. "You're very good, you know."

"What?" Sam shook his head, not understanding. Usually, if he confessed his love of life, was apologetic, looked sincere, he was given back the things that had been taken from him.

"How many times have you used that exact speech?" Sam blinked at him.

"I thought you said you didn't know me," he muttered darkly, collapsing into the chair.

"Well, I don't. I'm only _starting_ to. But I do know you're a smart young man and you've been around this block more than once. You know?"

"Obviously. So it that a no, Novak?"

"Well, _Winchester_ …" He smirked, pushing off the desk to sit in the chair across from Sam. "I think there needs to be some ground rules. I want you to be successful, and I want you to be able to take care of your basic needs. You shouldn't need the assistance of the nursing staff, but you also aren't really trustworthy in that aspect."

Sam sighed, looking down at his lap. He picked at the hem of his shirt. He really needed to stop doing that…

"Sam, this is the deal." Sam looked up again, meeting blue eyes that were regarding him carefully. "I will let you have a razor in your room, during hygiene times. It will not _stay_ in the room. And we will see how that goes for a few months. Does that sound okay?"

"Yes, _Cas_." Sam replied, feeling somewhat relieved. He really did want the razor to shave. Waiting four days for a nurse to have time to shave him was starting to get old. He brushed the back of his hand against his chin, feeling the stubble there.

"I didn't think you remembered." Dr. Novak, _Cas_ , laughed.

"I remember everything," Sam whispered, tearing his eyes away and returning his attention to the hem of his shirt.

"Yes, that's what I'm afraid of." And Sam didn't have an answer to that.

...

Sam opened his eyes, the darkness pressing down on him. He turned his head, looking at the dark corner of his room.

"Not tonight." He shook his head slowly. He felt the anger fill the room. His temperature rose and he let his eyes fall closed.

He was tired, so tired of fighting.

He heard the movement, the squishing sound of a footstep in blood soaked carpet. It made his stomach roll.

"Come and get me then," he hissed, pushing himself into a sitting position. "Do it. What are you waiting for?" He could hear his voice shaking; it matched the trembling of his body. "I'm here, I've been waiting, I'm ready."

And suddenly he was alone.

He felt it like a shot to the gut. A sob escaped his lips as he curled in on himself, pulling the covers up over his head, burying himself into his pillow.

He was always alone, always left waiting.

...

Sam could still feel himself shaking as he slipped into Cas' office, sinking down into the chair. Cas was already waiting for him, legs crossed and notepad balanced on his knee.

"Hey Sam." He smiled, watching as Sam adjusted into a more comfortable position. "How are you today?"

"Tired." Sam sighed, answering honestly. He could feel Cas watching him, studying him. He couldn't bring himself to care.

He hadn't cared about anything all day. He didn't eat, even after Bobby warned him he would have to mark his breakfast as refused. He didn't give a snarky reply to Charlie when she handed him his pills, earning him a confused glare and an extra set of vitals. He refused to share in group, another black mark added to his record.

"Did you have trouble sleeping last night?" Sam wanted to smirk at the 'doctor voice' he heard coming through.

"I don't need a sleeping pill." He glanced up quickly, meeting Cas' eyes. "Just… I'm fine."

"Alright," Cas said, leaning back again. "Do you want to talk about what happened last night that made you so tired today?"

"I never said anything happened." Sam felt his guard slowly raising; a shiver ran through him.

"I know you didn't. But it's obvious something did. In the two weeks we've been working together, you've never been this tired." He glanced down at his notepad. "You didn't eat this morning, you almost fell asleep in group. You've been off your game today, Sam."

"Does every time I pass gas get recorded too?" Sam let the annoyance he felt drift through his voice. Cas smiled.

"There's the Sam I know."

Sam fell silent, letting his hands fall flat against his thighs. He braced his fingers against his muscle, flexing his fingers open and closed.

"Sam… Tell me about last night." Cas' voice was almost a whisper, but it carried perfectly through the room, sending another shiver through Sam's spine. "Please."

Maybe it was the please, or maybe it was the desperate need to not be the only one plagued by his monsters, but Sam swallowed once, twice, and then started to speak.

"It… He was there last night." He started, letting his fingers fall still. "He comes at night sometimes, in the darkness. He doesn't speak, but I can hear him breathing, watching me. He's always… always covered in blood, in _their_ blood." He clenched his fists then, fingernails digging into the soft flesh of his palm. "He knows I can see him, he know I can hear the dripping, gurgling… And he just stares at me. He stares, and he breathes, and he doesn't come after me. Why doesn't he come for me?" Sam looked up then, expecting Cas to be jotting away on his legal pad.

"How do you know it's a he?" Cas whispered his question, leaning forward in his chair. Cas' own hand was twitching on his leg, like he was going to reach out for Sam, to offer him comfort. Sam snorted. Cas was just as likely to sprout confessions of his own demons as to offer Sam comfort.

"Because…" Sam stopped, shaking his head. "Because he _is_. He's… why? Why does that matter?"

"I'm just trying to understand." Cas shrugged his shoulders.

"He, she, _it_ killed my family. It killed them, murdered them, destroyed them. And I know he's coming for me. He told me so, he told me that I wouldn't be safe from him, that he would come. So what is he waiting for?" Sam felt his stomach lurch, eyes burning from unshed tears.

"I don't know," Cas replied, pushing himself out of the chair. Sam watched as he tossed the notepad onto his desk, running his hand through his hair, causing the dark brown hair to jut out into messy spikes. "I don't know, Sam," he whispered. They sat there in silence; the only sound was Sam's heavy breathing and the ticking of the clock on the wall.

 _Tick, tick, tick, tick._

Sam studied the muscles in Cas' back, contracting as he flexed his arms while he leaned over the desk. It may have been minutes, or even seconds later that Sam pushed himself out of the chair. He hesitated, waiting for Cas to say something, to stop him.

Sam let himself out of the room, leaving Cas still standing over his desk, surrounded by the ticking of the clock.

 _Tick, tick, tick, tick._

...

"Sam, would you like to share?" Terry, the group leader, smiled at him. Her teeth were pearly white, shining in the too-bright hospital lights. Sam wanted to knock them out.

"I don't really have anything to share today," he said, offering her the same sickly-sweet smile.

"Well…" She sighed, ticking off something on her clipboard. He heard the slight intake of the rest of the group. They all knew what the clipboard meant. "If you're sure, Sam."

"Well…" He felt something growing inside of him, thick black tendrils curling around his stomach, choking around his heart. "You know what? Yeah, I have something I want to _share_ with the class."

Terry's eyes flew up as she noticed his tone, and Sam felt himself smile. There was something so satisfying about this woman, this over-confident, over-dressed, overly-happy woman being afraid of him that felt so good. The tendrils continued to grow, to feed the beast inside of him.

"I have exactly five months, _five_ fucking months until I am done with all of this bullshit. I've been kept here, tortured and drugged, against my will because I was a child. But no longer. Five months, Terry, and I won't have to look at your fake ass smile or your ugly mug again. I won't have to pretend to care about the flavor of the groups' problem. I won't have to smile and offer my fake ass encouragement. Because you know what?" He pushed out of his chair and spun himself around to look at everyone in the group. "I. Don't. Give. A. Fuck. About. Any. Of. You." He pointed his finger with each word, landing upon Terry last.

He dropped back into his seat, body shaking and forced a smile on his face again.

"Sam Winchester. You need to leave this group," she whispered, voice shaking as she stared at him.

"Oh, are you going to _make_ me?" He spat out, laughing. Beside him, Bulimic-Megan was pale, and looked like she was about to vomit. At least she was good at that.

He hadn't _meant_ to say the last part aloud. But Terry was in motion faster than he ever thought she could move. She grabbed his arm, fingers digging into his flesh as she yanked him up and started shoving him back away from the group.

Her fingers were like talons, her grip tightening as she was whispering hotly into his face. He couldn't hear her words, he could only feel the heat of her anger, the force of her bones crushing into his. He felt his world spin.

"Stop," he whispered weakly, trying to pull away from her. "Stop. Let me go."

"Sam Winchester-"

 _"Sam Winchester!" His father's voice thundered through the house and he felt Dean stiffen beside him._

 _"What did you do now, Sammy?" He whispered, letting his eyes fall closed. They were sitting underneath the comforter of Dean's bed, playing with Sam's GI Joe Figures. He loved when Dean played with him. Even if he knew Dean was only here because it was raining out and Tommy down the road was on vacation, he would take it._

 _He let the action figure fall flat against the mattress, his shoulder slumping as their father's boots crossed the downstairs floor._

 _"I don't know," he whispered, pleading with Dean. "Come with me?"_

 _"Sammy, I can't. Dad hates that…" He watched Dean's throat as it worked to swallow. Dean was thinking about it, and if he pushed… Dean would come._

 _"It's okay," Sam said quickly, reaching for Dean's hand. "He probably wants me to get the mail or something." He smiled, slipping out of the safety of the comforter and leaving Dean in its false embrace. "I'll be right back, Dean."_

 _"Sammy?" Dean poked his head out, green eyes filled with unshed tears as he met Sam's. "Just… don't argue, okay?"_

 _"I won't." Sam smiled and slipped out of the room. He slammed right into his father's chest, palms flat against his father's stomach._

 _"I called you, boy," John Winchester snarled, gripping Sam's arms and lifting him off the ground._

 _"I… I know, Sir," Sam stammered, trying not to meet his father's eyes. He didn't want to see the disappointment there. Even at five, Sam knew he didn't live up to his father's expectations. He wasn't Dean… "I… I got stuck…"_

 _John snorted, dropping Sam from a few inches up so he could land back on his feet. Sam caught his balance quickly, using the wall as support, knowing better than to use his father._

 _"We're out of milk."_

 _"Yes, Sir," Sam said, nodding quickly. He felt himself tense as his father pushed past him, and John laughed._

 _"Are you scared of me, boy? Are you scared of your father?"_

 _"No…no…" A crack landed across his face; Sam saw stars._

 _"You should be."_

"You should be ashamed of yourself." Sam tore his arm away, shoving hard. When he opened his eyes, he saw Terry sprawled out on the ground in front of him. The anger he felt was instantly cool, turning to panic.

"Terry," he whispered, his head shaking back and forth as he pleaded with her with his eyes.

"Help! Code Grey! Code Grey group therapy!" Her voice sent a chill through him as she continued to scream. He stood there, frozen. Moving, apologizing, breathing wouldn't help him now. "He shoved me!"

Sam felt the pinch of the needle in his neck, and he welcomed the darkness.

...

Sam felt strange.

He swallowed hard, his tongue feeling thick in his mouth. His eyelids were heavy, and he fought to open them. He gasped as his eyes burned against the bright overhead light shining down on him.

 _Where the fuck am I?_

He swallowed hard, forcing himself to open his eyes again, keeping his line of sight downcast against the glare from the lights. He blinked a few times as he took in his surroundings.

He was in a hospital, but it wasn't _his_ hospital. He wanted to snort. The idea that the hospital belonged to him as much as he belonged to the hospital was… well, comical.

His heart started beating against his rib cage. No, this definitely was a real hospital. He looked down at himself then, seeing his hands enclosed in mitts, his legs strapped down to the bed. Panic made bile rise up to his throat and he thrashed his body hard against the bed rails.

"Hey!" He tried to scream out, his voice catching in his throat, a mangled cry the only sound that greeted him. He needed to calm down. He was in a hospital, that meant he was safe, right?  
The last time Sam had felt safe in a hospital…

He exhaled slowly, trying to calm his racing heart and collect his thoughts. He tensed when he heard voices outside of the door. He swallowed hard, preparing himself.

"He is _my_ patient." Sam knew that voice. He strained his ears, holding his breath.

"Sir, he has been admitted to our hospital for evaluation. According to his charts-"

"I don't give a shit about his charts. Have you read the updated information I transcribed this past week?"

"Dr. Novak," Ah. It was Cas. Sam wasn't sure if he should feel as happy as he did right then, but he couldn't deny the surge that went through him. "I trust you're aware of what transpired at your hospital?"

"I am. And it will be dealt with. However, it is against my medical opinion that he be subjected to this treatment again. I did not clear this."

"Well… I assumed that-"

"Whatever you assumed, it was wrong. Cancel the procedure."

"You technically don't have clearance at this hospital…" Sam missed the response from Cas, his tone dipping low. He waited another two heartbeats before the door was thrown open and his psychiatrist stormed into the room wearing low hanging sweatpants and a college sweatshirt.

"What the hell, Sam," Cas whispered, running a hand through his hair, looking down at him strapped onto the table. "Are you okay?"

"I don't know," Sam whispered, looking down at himself again. "I just woke up." Cas nodded, moving to the end of the bed to pick up a chart, scanning it quickly. Every few seconds he muttered something, but his attention never returned to Sam.

"Mr. Winchester?" A woman walked into the room, carrying a clipboard. "I'm here with discharge paperwork… are you the responsible party for Mr. Winchester's care?" She turned her attention to Cas and Sam tuned them out when a second woman came in to release his restraints.

Sam waited until he was alone with Cas before he slid his legs over the side of the bed and sat up, looking to his doctor for direction.

"Um," he said softly when Cas stayed staring at the wall.

"Do you realize how much trouble I could get into for this?" He said softly, and Sam felt his stomach clench.

"I didn't ask you to sweep in and rescue me." He didn't mean to sound so ungrateful, so short. He didn't ask, but he wanted. Cas had shocked him, the strange comfort Sam found in him had shocked him. Even his dreams had started to subside… But the words were out there, and the tension was palatable.

"Get up." Cas threw him a look over his shoulder and moved to the door. Sam obliged.

...

The silence in the room was suffocating. Sam could feel it, pressing down on his lungs, making is hard to breathe. He felt hot. A sweat broke out across his neck and his back. He swallowed hard, fighting against that too.

"Hello, Sam." Cas sighed, glancing up from his spot on the desk to meet Sam's eyes. "Go ahead and have a seat." Sam moved quickly to the chair, nearly tripping over the rug as he did so.

He didn't know why he felt so nervous. He had spent three weeks now with Cas as his therapist, and that was the longest amount of time he had ever had the same doctor. He should feel relieved, he supposed. Lately he found himself almost… _excited_ for his therapy appointments. Not that being made to talk about himself, his dreams and revelations, was enjoyable, but he felt himself opening up, comfortable even.

Today, Sam just wanted to vomit.

"We should talk about yesterday."

"I don't want to talk about yesterday." Sam knew he was being defiant. He knew he was being cold, he was letting the anxiety swirling around his stomach spill out of his mouth.

"I'm not giving you a choice."

Ah. There it is. Sam knew how this worked; he's been on the receiving end of this conversation many different times.

"Save it," he spat, hands shaking against his sides. "Just tell me when I get to meet my new therapist." Cas looked up then, confusion dancing across his face. Sam felt like laughing. He wasn't stupid, and it made him angry that this man would assume he wouldn't have figured it out.

"What? No, Sam." Cas shook his head, watching him carefully from across the desk. The new distance between them was strange, and Sam was drowning in it.

"I'm not stupid," he whispered, hot tears springing to his eyes.

"Sam." Cas chuckled, and Sam raged.

"This isn't funny!" He yelled, throwing himself into a standing position, crossing the distance so he was leaning over the desk, his face inches from Cas'. "You think I don't know? You regret putting your neck out for me yesterday. You've realized that no matter what you do, you can't fix this, you can't fix _me._ I am damaged, I am fucked. I am a poor excuse for a human who will never, _never_ be normal or a functioning part of society.

"I see him everywhere I go… blood dripping from his arms, eyes flashing when he meets mine because he knows, and I know, that I'm next. I don't know what he's waiting for…" Sam's voice cracked and he slammed his fists onto the desk, a container of pens toppling and sending its contents to bounce to the floor.

"Sam…" Cas whispered, tongue darting out to wet his bottom lip. Sam felt his stomach wrench at the expression on his face.

"You know it, too," he said, tears finally falling free. "And you're afraid of me. You should be."

"Damn it, Sam," Cas said, closing his eyes. Sam could see him shaking too, his hands pressed against the wood of the desk, his knuckles stretched and white. He needed to leave.

With a shaky breath, Sam pushed off the desk and turned towards the door. Cas was there immediately, his hands gripping Sam's arms.

Sam gasped, but his fingers were soft, heat radiating through them into Sam's bones instead of the pain he was expecting. He looked up in alarm, waiting for the memories to raise their ugly heads, the roil of emotions and bile to come crashing through his system.

Sam was greeted with the unexpected.

Cas leaned forward, pressing his lips against Sam's in a soft kiss. They were warm and soft, gentle and firm against his own. Sam gasped, his heart stopping in his chest.

"Oh my god," Cas whispered, dropping his hands and stepping back as if Sam were on fire. And maybe he was… "I… We… Fuck." Cas' eyes were blown wide and he stared at Sam, a new fear in his eyes. "I'm sorry. That… that was unprofessional." And the mask was back.

Sam just nodded, pushing himself around Cas, careful not to brush him as he fled to the safety of his room.

When he fell flush against the door, he allowed himself to lift his fingertips and trace them across his lips. If he closed his eyes he could still feel Cas' lips, hot against his own.

Sam had never been more terrified.


	3. Chapter 3

_Sam stiffened as he heard the door to his room creak open. He knew he was being ridiculous, it wasn't as if the door was slammed open. Nonetheless, he started shaking underneath the covers, squeezing his eyes tightly closed._

 _"Sammy." He exhaled the breath he was holding, flipping himself on the mattress._

 _"Dean." His older brother smiled sadly, pulling open the covers and slipping underneath them._

 _"You okay?" He asked, opening his arms so Sam could curl against his chest. He laid his ear over Dean's heart, the steady beat calming him. He focused on matching their breathing; when Dean inhaled, so did Sam. They exhaled together._

 _"I'm okay," he said after a moment. Dean squeezed his shoulders. He didn't believe Sam, but that was okay. Sam didn't believe himself either. "Are you?"_

 _"Course I am," Dean scoffed. "Just… couldn't sleep." Sam nodded, letting his eyes fall closed. "I'm sorry, Sammy," Dean whispered after a moment._

 _"You didn't do anything, Dean." Sam pulled back, squinting at his brother in the darkness. The soft glow from the streetlights outside their window made Dean's green eyes shine as they met Sam's own._

 _"I know. I didn't do anything, and I should have. I'm your big brother, I'm supposed to protect you." Dean's voice cracked and he shut his eyes._

 _"Dean…" Sam reached between them to pull Dean's shirt up. The sudden movement made his brother gasp and they looked down at the large purple bruise that was spreading across Dean's chest. "I didn't protect you," Sam whispered, running his fingertips over the spot, as if he could draw out all of the pain. They stared at the bruise together, both lost in their thoughts._

 _"Soon, Sammy." Dean finally twisted around, pulling his shirt back down and holding onto Sam again. "Just two more years, and I'll be able to get a job." Sam nodded._

 _"Happy Birthday, Dean," he whispered instead, letting his eyes fall closed again._

 _"Thanks, Sammy," Dean replied. Sam allowed himself to feel safe, wrapped in his older brother's arms. In two years, they could be free. Dean would be fourteen, and he had already been told by the Harvelle's he could be a busboy at their restaurant once he was old enough. Sam would be eight then, plenty old enough to help Dean too._

 _They just had to make it two more years._

...

"Charlie?" Sam asked, pressing himself against the wall of the hallway as Charlie came out of a room, pushing her cart.

"Sam?" She asked, surprised. "Are you okay?" He shook his head quickly, but the nurse didn't relax, just continued to stare at him. "I… Okay… What's wrong? You've never searched any of us out before." She laughed, almost nervous.

"I have to ask you for a razor." He shrugged. "Doctor's orders."

"Oh!" She laughed and Sam didn't know why it was funny. "Let me finish up in here and I'll bring it in to you, okay?" He nodded, socks skidding as he turned on his heel and made his way back to his room. He busied himself with filling a plastic basin with warm water, glad that even if he didn't have a shower, he still had his own sink.

He carried the basin over to the end of the bed, setting it down in the center. He pulled his shirt over his head, laying it over his pillow and climbed onto the mattress, careful not to upset the basin. True to her word, Charlie appeared with a razor, shaving cream and a few towels.

"Alright Sam." She handed him the supplies. "You have to keep the door open, and I'll come in a few minutes to see how you're doing."

"Yeah," Sam said, slipping the plastic protector off of the blade and dipping it into the water. By the time Charlie returned, he was wiping the last remains of shaving cream off his face and folding the towels up.

"Let me see," she said reaching for his face. Sam flinched and was grateful when Charlie released him. She smiled sadly, picking up the razor, trying to hide the fact that she was checking and counting each blade.

"I just wanted to shave." He sighed, reaching for his shirt.

"I know Sam. Protocol." She smiled sadly at him, taking everything with her when she left. Sam stood then, slipping the plastic protector from the blade into his pocket before leaving his room to go to the public bathroom. He planted himself in front of the mirror, leaning forward to look at his reflection.

He was pleased to find he hadn't missed any spots, nor managed to nick himself. He pulled back slightly, studying his face. He had large, purplish circles underneath his eyes, his cheekbones hollowing. He was pale, hair falling in greasy, twisted strands into his eyes. He pushed it back, sighing. His eyes fell on his lips and he froze, lifting his hand to brush against them.

His thoughts immediately went to Cas, and their kiss from yesterday. He found his heart racing in his chest, a sweat breaking out across his body. He had less than an hour until he was supposed to see him again…

He reached for the faucets, turning the water on hot and at full blast, tipping his head down to wash at his hair. He didn't know why it mattered… Cas had seen him in worse states than with greasy hair… His fingers dug against his scalp, massaging the roots furiously. As if it would help him get clean, as if he could ever, truly, be worth it.

He wrang out as much of the water as he could, flipping his hair back to slap against his shoulders. He stared at himself again, cringing at his reflection. On his way out the door he paused, fingers toying with the plastic cover before he pulled it out and flicked it into the trash.

He could always get another one if he wanted.

"Sam!" He heard Charlie calling from behind him and he stopped, hand hesitating on the door to Cas' office.

"I have my therapy appointment," he said, waving at the door.

"Not today, Dr. Novak called out sick." She smiled at him sadly. "I can get you in to see Dr. Braeden if you would like?" She cocked her head and Sam shook his head quickly, trying to decipher the feeling that was swirling through him.

"No. I just… I can't go to group, they told me to go to therapy instead."

"Well, I guess you get an afternoon off then." She smiled at him and Sam knew he was supposed to smile back. Three weeks ago, he would've been ecstatic. He would've jumped at any opportunity to be free of therapy, group and any other obligation the hospital deemed him worthy to have. Today, Sam felt empty.

"I'll just… go back to my room." She smiled at him as he passed and it made Sam want to scream.

He slipped back into his room, falling on his back onto the bed.

He wasn't stupid.

Cas was avoiding him.

This was the end.

...

"Hello Sam, sorry I missed our appointment yesterday." Cas was speaking, but Sam couldn't move. He was frozen in the doorway, staring at a woman who was sitting in Cas' usual seat, glasses pushed high up on her nose as she watched him carefully. She had short brown hair, flipping out at the ends.

"Who are you?" Sam asked, crossing his arms over his chest. He looked up at Cas to find the other man busying himself with paperwork on his desk, refusing to meet Sam's gaze.

"I'm Doctor Mills." She smiled, standing up to cross the room, hand extended. "I am in the undergraduate program at Stanford University, and working to finish my Clinical hours."

Sam stared at her outstretched hand, then turned to look up at Cas.

"Why is she here?" Cas looked up then, an expression Sam couldn't read crossing his features. He was guarded, blocking Sam out. Sam was surprised at how much that hurt.

"Dr. Mills is a student and needs clinical hours to complete her residency. I offered to have her sit in on our appointments, she can observe or take over, depending on the situation. I think it will help us all."

"I refuse." Sam crossed his arms, shaking his head at them both, ignoring the strange look that came across the woman's face.

"Unfortunately, as a ward of the state…" Cas trailed off, he didn't need to finish. Sam knew. As a ward of the state, Sam wasn't given any rights. His 'guardian' would sign off on any procedure, any test, any piece of fucking paper that passed over whoever's desk, without a care to Sam's personal thoughts or feelings.

"Well, have the state come and fucking get me then," Sam said, spinning on his heel and wrenching the door open. "And fuck you, _Dr. Novak."_

...

 _Slam._

 _Slam. Slam. Slam._

 _"Sammy, I'll be right back."_

 _"No, Dean, don't go down there," Sam pleaded, pulse jumping in his throat as the pounding continued. Slam. Slam._

 _"It's okay." Dean smiled, flashing two rows of perfect teeth. Sam ran a tongue over his own teeth, pushing into the empty socket where one of his buck teeth used to be. "I'll be right back."_

 _Sam closed his eyes tight, listening to his bedroom door shut again. His heart pounded in his chest and he tried to count as high as he could until Dean got back._

 _35, 36, 37. Slam._

 _62, 63, 64. Slam._

 _Slam. 89, 90, 91, 92._

 _"Dean?" Sam's eyes shot open as he heard the door open again, Dean's feet immediately coming into view._

 _"It's okay, Sammy. Daddy's just hanging up pictures." Sam's eyes widened._

 _"Really?"_

 _"Yeah." Dean's smile widened and Sam couldn't help but smile back. It was going to be okay._

...

 _Dear Doctor Novak,_

 _You once told me you wanted me to write in a diary. I think that's stupid. I would much rather talk to a real live person. So, your wish is my command._

 _I think you're an asshole._

 _I think you're afraid of what you did._

 _I think you want to do it again, and I think I want you to._

 _What is it that bothers you the most? The fact that I am your patient, and you're my doctor? Or the fact that everyone around us thinks I'm batshit crazy?_

 _Sincerely,_  
 _Sam Winchester,_  
 _Room 201 (incase you forgot)._

Sam folded up the paper, a strange sort of satisfaction settling in his stomach. He had successfully avoided Cas for two of their sessions after seeing Dr. Mills sitting in the office, waiting for him. It was only a matter of time before Cas would actually have to report his absence… And Sam wasn't going to force the hospital director's hand in changing his psychiatrist.

He would participate. He would answer Dr. Mills questions. And he would make it completely unbearable for Cas to sit through.

Making his way to the office, he smiled at Dr. Mills and tossed the folded paper onto Cas' desk, ignoring the questioning look he received.

"Mr. Winchester," She looked up, shocked expression on her face. Sam nodded at her, sinking back into the chair. "What a pleasant surprise."

"I had nothing better to do." He shrugged, flashing her a smile. "I supposed I could grace you both with my presence."

"Glad to hear it." She smiled, and it was genuine. Sam didn't know how he felt about that. He ached to look over at Cas, to see the expression on the other man's face and know that he was the one that put it there. But he had to refrain, wait it out, and make him sweat. "So, Sam, tell me about yourself."

"I'm not really sure what there is to tell," Sam shrugged.

"Tell me about the things you like to do." Dr. Mills smiled, her hands already flying across her notebook.

"I've been a patient here since I was seven years old." Sam said, tone flat. "I live in a hospital, I go to group and therapy. There isn't anything for me to do."

She smiled at him, waiting. The silence that surrounded him was nothing like the comfortable silence he was used to in this office. He was suffocating, pressing down on him, choking him. Sam glanced up and over to Cas' still form. The man's hands were clenched around the letter, eyes staring into the paper, to the desk , to Dr. Mills – anywhere but to Sam himself.  
This was a mistake.

Sam swallowed hard, feeling the panic rising in his chest. He let his eyes fall back on Dr. Mills, her sickly, sweet, smile still plastered on her perfect little face. She licked her lower lip, blinking calmly as she stared at Sam, her pen tapping against the pad of paper on her lap.

Something flashed in her eyes and it made Sam's stomach turn. There was something about her that was making his head spin. He tore his eyes away, focusing his attention on the drawstring of his scrub pants. He could feel her watching as he dug his thumb nail into the plastic-coated end, breaking it apart until the string started to unravel.

"Do you want to talk about your family?" Sam's eyes flew up at the suggestion. "January 24th today, wasn't that your older brother's birthday?"

"I don't-" Sam shook his head , squeezing his eyes closed. It was Dean's birthday. How could he forget? He swallowed again and she continued.

"Do you remember much about your brother?"

"I remember everything." Sam could hear her talking, the sound of her voice slowly fading away.

Dean would've been 21 today.

He would've had Sam be the designated driver and Sam would've griped about being made to sit in the car while Dean went into every bar he could find.

Dean would be drunk, and laughing. Happy and alive.

Instead, Dean was dead, frozen in time in a pool of his own blood, green eyes staring up into nothing.

 _"_ _Dean!" Sam threw himself onto the floor, eyes wide in shock as he took in the scene before him. Dean was laying at the bottom of the stairs, his body twisted in a weird angle. Sam grabbed his shoulder, ripping him back, and screamed._

 _Blood was everywhere. It covered Dean's neck and chest, was pooling under his body. His skin was pale but his eyes… Sam felt himself start to shake as he stared down at his brother. Dean's blood was soaking in through his shirt, tacky and cool as it slid against his exposed skin. "You promised, you promised!" Tears were rolling down Sam's cheeks, falling onto his brother's lax face. For once, Dean looked calm, completely at ease._

 _His green eyes were crystalline, clear, and shining in the dim light. A false representation of life._

 _Sam wanted nothing more than to join him._

Sam could feel the blood drying on his arms, stretching the skin as it cracked and peeled. He scratched at it, digging his fingernails into his flesh, desperately trying to get it clean.

"Do you want to hurt yourself right now, Sam?" He snapped to attention, eyes finding Dr. Mills staring at him, an eyebrow raised. He looked at her, confused. She waved her hand and he looked down at the thick, red welts he was leaving on his forearms.

"No." He whispered, still scratching. Still dirty.

"Are you sure?" Sam blinked again, focusing his attention back on her, back into this room and not in the blood drenched foyer.

"Yes, I'm sure."

"You don't look sure."

"Jody…" Cas' voice had a warning tone to it, but Sam didn't care, couldn't care. This was between him and Dr. Mills, Cas had made it that way. The rest of the room fell away.

"I am sure," he said, shifting forward and forcing his hands to rest still in his lap. "I think I know my own head better than you do."

She smirked. "Are you sure about that?"

"And what exactly does that mean?" He could feel Cas' eyes staring at him, pupils blown wide. His mouth was open and he was saying something, but Sam couldn't hear him. "Please, enlighten me then."

"December 4th, 1990 tragedy struck Lawrence, Kansas as a family was ripped apart. Dean Winchester, 11 years old and Mary Winchester, 36 years old were found murdered in their family home. John Winchester, missing and Samuel Winchester, 7 years old, was found in the hallway covered in blood."

Sam swallowed hard, eyes never leaving the cool ones staring him down. He was vaguely aware of Cas still sitting in the room and he forced himself not to think of the other man. He didn't want to see Cas' face as his bloody childhood was poured out in front of them. It was stupid, Cas already _knew_ everything about him. But hearing it, having the words hang thick around them, made everything different.

"Samuel Winchester was checked out by the responders at the scene and no defensive wounds, or any injury, were found despite the boy being covered in blood from head to toe. He was spouting about how he watched his family get ripped apart by a monster, cried that his brother was supposed to save him and they were going to be free.

"The murder weapon was found on scene, tiny, tacky fingerprints pressed into the handle. When asked, Samuel Winchester replied that it had been the monster's claws, jagged and messy that had torn into his family. He was jumpy, panicky that the monster would come back and finish him off."

"Well, seems like you read my file." Sam whispered, trying to keep his voice steady and the images rolling around in his head at bay. The knot in his throat was threatening to choke him and he struggled to breathe. "That's not what I asked. I didn't ask for my story to be reiterated. You said you knew my head better than me. Prove it."

"You're sick, Sam." She said, eyes flashing and Sam swore he saw red. "I remember being a teenager, sick to my stomach as I watched the news that night, watched them bring this little boy covered in blood out of that house. I had nightmares about it, that my brother would snap and murder my family in the middle of the night. As rare as it it? It's not impossible for schizophrenia to manifest in a young child. What was a normal 'monster under the bed' fear for other children, became reality for you. Until one day you snapped and saw your family as the monsters you feared so much. Your hallucinations, both auditory and physical manifestations, made _you_ murder your family in cold blood."

"Doctor Mills!" Cas' voice was loud, shattering the silence that fell across the room.  
Sam felt his heart stop in his chest, the knot in his throat suddenly gone, replaced instead with fire. He was shaking, fingers balled into fists. But she couldn't stop; Sam recognized the fire behind her eyes and found it comforting. This he understood; this he knew how to handle.

"You're a sick little boy, Sam Winchester. And I think you enjoy this, you enjoy the materialization of your faults in that of a fairy tale monster. You thrive from the attention you gain here. You have no-"

"Enough!" Cas yelled and Sam gasped, feeling a hand pressing against his chest, separating him from Dr. Mills. He didn't know how he got there, standing up from his chair and inches away from Dr. Mills who was being held back by Cas' other hand. Sam looked up, searching for Cas' face. "You are out of line." Cas' voice was low, dangerous as he stared down the other doctor.

"I…" She shook her head, fear dancing across her face as she fell back into her empty chair. "I don't know what just… oh God…"

"Sam, you can leave." Cas let his hand fall, eyes stuck on Dr. Mills.

"But…" Sam immediately missed the warmth of the other man's touch, longed to see the expression in his eyes.

"Go." Sam swallowed down the hurt, the feeling of betrayal as Cas kicked him out of the room.

The one room he actually felt safe in.

Sam was a fool to think he would ever be anything except alone.

...

"I want to make a deal with you." If Az was shocked, he didn't show it. Instead, he leaned back against his bed, crossing his feet at the ankles, smirking at Sam.

"Didn't expect to see you, Sammy." Sam bit his tongue, holding back his retort.

"Are you going to deal with me or not?" Sam sighed, shoving Az's legs over and sinking to the end of the bed. Az stared at him, yellow eyes blazing.

"I don't make deals." He whispered, a verbal punch to the gut. Sam let his eyes fall closed, sighing. "But… I think you have _potential_ , Sammy."

"Potential for what?" Sam asked, shaking his head.

"Doesn't matter. Here's your deal, let me call you Sammy."

"Seriously? That's what you want from me?" Sam snorted, ignoring the nausea that rolled through him at hearing the name.

"Yes, that's what I want. It has… a certain ring to it, don't you think? A familiar sound, as if we were _family_." Az spoke softly, his voice carrying through the room, sending a shiver down Sam's back.

"Fine." Sam nodded, "You can call me it."

"What would you like, Sammy?" Az purred, smirking.

"You know what I want."

Az smiled.

...

Sam sat cross legged on his bed, the scratchy comforter pulled up across his lap, when a knock came from his closed door. He looked up, expecting a nurse with new pills, or Az with more games. He did not, however, expect to see Dr. Cas Novak pushing into his room, hands shoved deep in his pockets.

"Hey, I… I wanted to make sure you were okay." Cas ran a hand through his hair, pausing to scratch at the base of his scalp before looking up at Sam. "Are you okay?"

"Yeah. I'm fine. Why wouldn't I be?" Sam shrugged, staring at him. His heart was pounding in his chest. Part of him wanted to scream. To toss back the blanket and go to Cas, to tell him everything. The other part of him knew that it was useless. _He_ was useless.

He was the reason they were dead.

He was the reason he was alone, and locked up in the first place.

"Okay, if you're sure?" One of Cas' hands slipped from his pocket and Sam watched as he inched it towards the door handle, desperate to release himself back into the hallway. Sam couldn't blame him, not really.

"Fine."

"Okay, well, good." Cas nodded quickly, fingers finding the knob and turning it behind him. "I'll see you tomorrow then?"

"Sure," Sam shrugged again, tearing his eyes away. He knew Cas' was hesitating at the door, so he twisted himself down into the covers, rolling onto his side and pretending he was going to sleep.

The door shut quietly.

Sam was alone.

...

"I was waiting for you." Sam twisted the knife between his fingers, the blade reflecting on the moonlight that was shining in from the window. He could feel the eyes on him, the scent of blood slamming into him. He looked over to the corner of the room.

 _He_ was there, soaking in the darkness. Sam didn't need to see him to know he was smiling, blood dripping down his face. Sam flipped the blade over again, waiting.

"I'm done with this." Sam's voice felt strange as he whispered into the dark. He rolled the words around in his head before letting them fall from his lips, his self proclamation to the monster that ruined his life. As he flipped the blade again, he couldn't stop the pang in chest or the question that rang through his head: _Are you talking to the dark, or to yourself?_

And Sam didn't know anymore. He didn't know why he was fighting, _what_ he was fighting. He let his eyes flit back over to the corner of the room, pleading with the presence there.

"I need this to end," he whispered, tears clogging his throat. "They can't fix me, and it's my fault. I never should've left Dean… You killed him, _we_ killed him." The sharp sting of the knife cutting in his flesh should've made him jump, but he welcomed the pain and the warm blossoming of blood that came with it.

He dug the blade deeper against his arm, dragging it slowly and watching in the dim light as the blade split his skin apart as if he were cutting into a stick of butter. Blood welled, building up before falling in thick rivulets down his arm. He moved the blade again, pressing it at the base of his wrist and beside the first cut. This time, he gasped as the point broke his skin, and the burn as he dragged the blade up made the tears finally fall.

"This is what you wanted," he whispered, pressing the blade flat against his mutilated flesh and watching the blood pool across the metal. "Isn't it? Isn't this what you wanted?"  
His head snapped up and he was greeted with nothing. There was no one there but him.

"Maybe I was the monster all along." He looked down at his arms, head starting to spin. His legs felt wet and warm and all he could think about was his brother's body lying in his arms.  
He shouldn't have left Dean alone, hiding in the shed and pretending the monsters didn't exist.  
Dean shouldn't have had to worry about him at all; Sam was old enough to take care of himself, and that's what he should've done. Instead, he had let his older brother take the fall, left him alone when they had sworn, promised one another, they would never be apart.

Sam lied. Sam had run, and hid. And Dean had died.

It started in blood; it should end in blood.

It was his fault, after all.

...

He shouldn't be in pain. He shouldn't be feeling anything.

Nausea rolled through his stomach, but it felt miles away. His head was drifting, unattached. The pain in his arms was stabbing and burning, but he couldn't pinpoint _where_ they were. He felt pressure, fingers wrapping themselves around him, and he screamed.

"Don't!" Sam's scream morphed into a yell and he twisted away from the hands on his arm. He gasped, choking on the air he was trying to desperately to take in.

"Sam! What did you do?" Pain, a different kind of pain than what he was feeling, filtered through the voice and Sam struggled to place it. "Fuck, Sam. Stay with me… I knew I shouldn't have—Can I get some help in here?" The voice grew louder, more panicked. The pressure on his arms increased and Sam wanted to scream again.

He wasn't supposed to be in pain. Unless this was Hell…

He tried to pull away, gasping when his arms were jerked painfully above his head. More voices entered the room and Sam felt himself spinning again. Too much pain.

He tried to yell, to make them understand. He just needed his brother, Dean would make it all better, Dean would have to forgive him. _Dean, I'm so sorry._

"Shhh, Sam. You're going to be alright. Just hold on for me, okay?" He swallowed hard, forcing his eyes opened. Concerned blue eyes were staring down at him, relief fluttering through them when they met Sam's eyes. "Oh, Sam…"

 _Cas…_ and then darkness once more.


	4. Chapter 4

Notes: This chapter was beta'd by Oldbatj.

* * *

 _Silence fell over the room and Sam froze, waiting for his brother to make the first move. They were curled up in Sam's twin bed, watching the lights flicker against the wall as their Dad's truck went rumbling down the drive, gunning off in search of the closest bar._

 _Sam's hand was going numb where he held the bag of frozen peas against his hip. It was doing more to freeze his hand than to ease the pain radiating down his leg. He tried to shift, quietly in case Dean had fallen asleep._

 _"I think I hate her, Sammy." Dean's voice broke the silence, cracking and twisting something deep inside of Sam. Sam reached for his brother, letting the peas slide off his hip only to fall forgotten on the mattress. He stroked his thumb over Dean's cheek, wiping away the tear that was rolling down his brother's face. "Who hates their own mother?" More tears and Sam couldn't possibly brush them all away._

 _It was okay, he could be strong for Dean tonight. He opened his arms allowing his brother to sink into them as the boy fell apart. Sam shushed him, running a hand through his hair, just like Dean usually did for him. Dean's sobs shook their bodies, and Sam tried to rock him, their size difference making it awkward and causing pain to course down his leg again._

 _"I shouldn't hate her, but I do, Sammy. I hate that she does nothing. I hate that you got hurt again. I hate this, I hate living here, I hate that I can't do anything, that I'm not old enough, that I'm not good enough to protect you. I hate-" Dean cut himself off, sobbing too hard to form words. Sam clung to him and whispered that it was okay, they were okay._

 _Finally, Dean's sobs turned into shuddering gasps. He reached between them to wipe at his face, taking in a sharp breath. "I'm sorry, Sammy."_

 _"Don't be." Sam replied, squeezing his hands around Dean's back. "I love you, Dean."_

 _"Love you too, Sammy," Dean whispered, twisting them so they were laying side by side, hands clasped underneath the covers. Sam leaned forward once more, wiping the residual tears off his face and pressing a soft kiss against Dean's brow. "Thank you."_

 _Sam smiled and let Dean hold on, glad he could be the strong one, even if it was just this once._

Sam reached beside him, the bed he was in cold and empty. Dean wasn't here. He hadn't been here in a while. It was Sam's fault.

He closed his eyes, carefully wrapping his arms around his ribs, trying to ignore the throbbing pain in his wrists. He didn't need to open his eyes to see where he was. It wasn't the first time he had been moved into solitary confinement for his 'safety'. He let the tears fall freely, not caring if they were watching, not hoping that they were.

Sam felt empty; even the darkness had left him. He had never felt more alone.

* * *

 _"Don't you dare tell me how to raise my boys! Sam! Dean!" Sam's eyes flicked quickly over to his brother's and were met with a wide-eyed, frightened stare. Sam racked his nearly four-year-old brain, wondering what the heck he and Dean could have done this time…_

 _He looked around the living room; they had picked up the colored pencils and their shoes were lined at the door. He hadn't even had a chance to get to the GI Joes yet today… Sam bit on his lower lip, mimicking the motion Dean did when he got nervous and allowed his brother to pull him up off the floor._

 _"Come on, Sammy," Dean tried to give him a small smile, but Sam knew his brother was just as worried as he was. Lately, Daddy hadn't been very happy with them at all… Their mother had tucked them into bed last night and after reading from The Lion, the Witch and the Wardrobe, she had started to cry. Sam had never seen his mom cry before…_

 _"Momma?" Dean sat up, pulling on their mother's shoulder to get her to face them. "Momma… what's wrong?"_

 _"You boys just need to be really, really good this week, okay?" She blinked back her tears, wiping her nose on the back of her hand and Sammy wanted to tell her she wasn't supposed to do that, wanted to crawl out of bed and get her a tissue or at least a clean shirt, but her arms were suddenly around them both, hugging them tightly._

 _"Were we bad today?" Dean's voice was muffled against her chest and Sam almost had to fight to breathe as Mary's arms tightened around them._

 _"No, no… of course not, honey" she pulled back and smiled, a small and watery smile that had something hurting in the middle of Sam's tummy. "But Daddy is stressed right now, and he's going to be home more often. Okay? And we have to be really careful that we don't bother Daddy while he's working in the house. Okay?"_

 _"Okay," Sam agreed, anything to get his mom to stop crying. Dean however, had questions._

 _"Why isn't he going to work? He said he was gonna be leaving next week for New York for a few days… then he-"_

 _"Daddy doesn't work there anymore, okay?" Mary patted Dean's head, smoothing down his hair. "Daddy is going to get a new job but we have to give him some space and some quiet so he can do that, okay?"_

 _Sam looked at Dean and when he saw his brother nod, he nodded too._

 _"Yes, Momma." She smiled and tucked them both into bed, kissing their foreheads before slipping off of the mattress. "'Night boys."_

 _They had been on their best behavior since waking up that morning, even tiptoeing when they had to go anywhere near their Dad. Even Momma was being quiet as a mouse._

 _"Dean…" Sam whispered, following his brother into the hallway. "We listened to Momma… Were we being loud?"_

 _"Shush, Sammy. Come on," Dean tugged him forward and they walked side by side into the kitchen. Mary was crying again and Sam was suddenly scared. He looked up at his mother, her arms were crossed over her chest and she looked like she was trying to sink into the space between the cabinets and the fridge. Their Dad was standing beside her, his hands at his sides clenched into tight fists._

 _"Daddy?" Sam asked, and John's eyes pinned him to the spot._

 _"Did I ask you to speak?" his father growled. Sam shook his head quickly and stared at him, eyes wide. "Your mother seems to think that I don't know how to raise you boys, seems to think that I can't handle being a father, handle staying home and watching you boys all day. What do you think? Do you think I'm a bad father? Sam? Dean?"_

 _"No, Dad," Dean stammered quickly and shook his head, Sam followed suit, afraid to speak again in case he wasn't really supposed to. John laughed and it wasn't a happy sound like Sam was used to. He looked up and saw his Dad was staring at their mother again, his face looked angry, scary._

 _"Sam, come here."_

 _Sam stumbled forward, tripping on his sock and almost fell straight into John's knees. John's hands were on his arm quickly, snatching him into a upright position, but his touch was anything but helpful. Sam heard himself cry out at the tight grip his father had on his arm, his fingernails were digging into the skin and into his armpit. Tears were suddenly in his eyes._

 _"Dad!" Dean moved forward and pulled Sam back; Sam thought his arm was going to be ripped off and he clutched it against his chest. He looked up, tears swimming in his eyes and marring his vision, and he suddenly wanted to run._

 _John moved quickly, back-handing Dean and causing the seven-year-old boy to fall to the floor. Sam stared, eyes wide as their Dad's boot connected with Dean's stomach. Their Dad was kicking Dean… and it didn't make sense, not one bit of sense at all._

 _Daddy was supposed to sneak them extra dessert when their mom wasn't looking, he was supposed to help them build tree forts in the back yard and dig up nightcrawlers in the garden to go fishing with in the morning. Sam wanted to scream, he wanted to cry and to run away as far and as fast as he could, away from the scary man who was screaming and kicking his brother._

 _But Sam couldn't move. Mary's arms were around his shoulders, holding him in place, forcing him to watch. Her tears were falling down into Sam's hair, wet drops falling through his hair behind his ears and making him shiver._

 _All Sam could hear was Dean crying, pleading with John to stop. All he could see was Dean curled in on himself, clutching his stomach and crying; his face and eyes wet with tears and snot._

 _"This is all your fault," John was suddenly right in front Sam and the little boy flinched in his mother's arms, almost happy when he looked up and realized his Dad was staring at his mother and not at him. "I don't know what the hell you let these brats get away with, but it's changing now. We're going back to doing things my way, Mary. You understand me?" Mary flinched, nodded, and then released Sam and left with John._

 _Sam fell to his knees and crawled, sobbing to Dean's side. He patted Dean's hair, wiped at his eyes and his nose. "We just have to be good, Dean, we just have to listen to Daddy." Dean only sobbed harder, but Sam knew he heard him, knew he would nod if he could. Sam lay on the floor with Dean and hugged him and the two of them just cried and cried._

* * *

"Mr. Winchester?" He could hear the voice beside him, could feel the presence crouching down, his skin aware of the soft fabric of the scrubs grazing his fingers. But he didn't respond, couldn't respond. He kept his eyes closed and focused on his breathing. In and out. In and out. In and out. "Sam? Sam, I know you can hear me…" A sigh, and then the presence was gone.

In and out. In and out. In… and out.

* * *

"Doctor Novak… he isn't responding. We've been able to give him his medications intravenously and he's been on the IV for fluids since he's gotten here… but it's been four days. He hasn't eaten, he hasn't gotten up to go to the bathroom on his own, hasn't uttered a single word unless he's been asleep. And even then the dreams …"

"Thank you, Charlie," Castiel Novak's voice was warm and Sam wanted to open his eyes, wanted to see the look of disappointment and anger in those bright blue eyes, directed right at him. But he couldn't. Couldn't open his eyes, couldn't move, could only breathe.

In and out. In and out.

"Last time he went into a catatonic state we-"

"I'm aware, Charlie," Castiel spoke again. "I know what was done last time, but it's a last resort. It's only been three days, and Sam's body has gone through quite a bit since then. This is…" Castiel sighed and his voice dropped lower, as if he knew Sam could hear him, as if he knew Sam was listening. "I think that Sam's has put himself into a catatonic state—completely voluntary, although I don't think Sam had any real control over it. He…" Castiel sighed again, deep and long.

"Sam was starting to do so well…"

"I know, Charlie. I know…"

"If you need anything Doctor Novak, I'll be right outside. Sam… I think Sam's a pretty special kid, you know?"

"I do, thank you, Charlie."

Sam heard the door close, and then shoes shuffling around the room and finally the drag of the chair being moved closer. Then he was blessed once again with silence.

In and out. In and out. In and out.

* * *

 _"Dean!"_

 _"Sammy what did you do? What the hell did you do?" Dean grabbed Sam's arms and shook him, though Sam knew his brother was scared, not angry at him, and he tried not to flinch away from the contact. He wouldn't flinch from Dean, never from Dean._

 _"I didn't mean to! I was aiming for the tree and then..."_

 _"Shit! Sammy…" Dean closed his eyes tight and Sam knew what was going through his mind. Dad was going to kill him. Sam was going to be dead once John came home from the store and saw the garage door window blown out._

 _"I… I should run away," Sam suggested suddenly, and Dean's eyes flew open in shock._

 _"What? Sam… You're six years old. What the heck…"_

 _"You could come with me. We could do it, Dean. We could take the tent and live in the woods. I know how to get the nightcrawlers and we could eat fish and mushrooms and berries and stuff. We could just go camping for… for life. We could bring a sleeping bag and I wouldn't even care if we had marshmallows because we would be-"_

 _"Sammy, we can't. We can't run away." Dean's voice was soft, and Sam stepped back from him, hurt._

 _"Why, Dean? Why not? Why should we stay here? Dad hates us! You know he does! He hates everything about us, about having kids. What he does to us… You don't see the kids at school coming in like we do!"_

 _"Sam, stop," Dean was shaking his head, moving closer to Sam. But Sam didn't want it, not this time. He didn't want Dean to comfort him and tell him that eventually they would free… that eventually they would be safe. Because eventually didn't help him now._

 _"No, Dean! I don't want to stop! I want to run away. I want to get away from this house and from Dad and from Mom. And if you don't want to go with me? Then I want to get away from you too!" Sam didn't wait for a response, he turned around and ran into the back yard, away from the garage window he busted by kicking his soccer ball too hard, away from Dean standing in the driveway with outstretched arms, away from the Impala that was slowly creeping down the street._

 _He clambered up the tree trunk ladder and threw himself into their tree house, the last good thing that John had ever done with them. Sam had been glad to start kindergarten, glad to get out of the house and out from under his Dad's eyes, even though he was only in Mrs. Willis' class for four hours a day. When he heard the other kids, laughing and talking about their moms and their dads, family fishing trips and baseball games and trips to the beaches and the zoo he wanted to cry. And Sam hated them, he hated every single one of them._

 _None of those kids ever wanted to run away. None of them were ever so scared they peed their pants at the dinner table because they had knocked over a glass of milk. None of them had ever climbed a tree in the backyard to escape their father taking off his belt, knowing that they would have to come down sometime and that their punishment would be so much worse, but holding onto the branch until it was way too dark to see anything anymore and were forced to trudge inside to take off their shoes and lay over their Dad's laps with their pants around their ankles to count each slap of his palm or belt against their butts._

 _Sam hated them all, but he hated John the most._

 _Angry and scared, knowing when their father did get home he would be in more trouble than he ever dared to think, Sam started ripping things off the walls of the tree house. The posters of the Star Wars movies Dean loved, the pictures and pop up books off the shelves. He upturned the small wooden table John had built and tried to rip off the legs, screaming out at it when they wouldn't budge and Sam's hands received several splinters instead. Breathing hard, Sam threw himself onto the floor and pulled his knees to his chest and started to cry._

 _It felt like hours that he lay there, sobbing and alone in the wrecked tree house before he stopped. He had to go inside. Had to tell John what he did. No matter what he had said to Dean, it wasn't fair to blame him or force his brother to leave. They couldn't run away anyways, not really. They wouldn't make it, and going back to John and their mom after that? Sam shivered._

 _Slowly, he crawled towards the ladder and opened up the hatch to start on his way down. When he got to the bottom he gasped when he almost stepped on Dean, his legs stretched out from where he was sitting, back against the tree._

 _"Dean?" Sam took a step forward, guilt swirling through his stomach when he saw his brother's face – his eye was bleeding, cheek purplish and huge. Dean's eyes were still bright, green and determined as they stared up and met Sam's._

 _"We can't leave now, Sammy. Not yet. But we will, okay? I promise you, I will get you out of here as soon as I am big enough to do so. We will do it right, okay? I'm saving up any money I get my hands on… allowance or birthdays or whatever, okay? And I'll get us out Sammy, I promise, okay?" Dean's voice was thick and he started to cry, wincing as the salty tears rolled over his swollen cheek. "I promise, Sammy. I promise."_

 _"Okay, Dean," Sam dropped down beside his brother, folding himself under his arm and laying his head against his chest. He let Dean cry, let himself be held, and let himself hope that Dean could do it, could get them out of there._

 _"I'm so sorry, Sammy. I promise you… I promise." Dean whispered his mantra and Sam nodded, stroking Dean's leg in the process._

 _"I know you will, Dean. I'm sorry I made Dad mad… I'm sorry he thought it was you. I will be good. I'll be really good until then, okay, Dean? That's my promise. I promise you I'll be good and you won't get hurt because of me."_

 _"Okay Sammy," Dean held Sam a little tighter and Sam prayed that he could keep his promise. If not for him, then for Dean._

* * *

"Doctor Novak?" Sam felt himself stiffen at the voice in the room. He had tried to keep track of the days, of the voices and the comments thrown in his direction. He had mostly been able to recognize Charlie and Cas, one time even Bobby. But this voice was new…

"Yes?"

"I'm Doctor Joe Burnett, from Johns Hopkins Research Hospital."

"Ah, yes. What can I do for you today, Doctor?" Silence, a shuffling of feet.

"I… I specialize in Adult Psychiatry, focusing mostly on early onset psychosis and schizophrenia. We have an excellent program and end up seeing a solid sixty percent of our patients able to return back to a normal and functioning lifestyle."

"That's very impressive, and I've heard of your work and that of the hospital. It's important, but I'm not sure what that has to do with why you're here…?"

"Samuel Winchester… is a special case. And as he is reaching adult hood, we would like to-"

"No."

"I'm sorry?"

"No, I will not release my care of Sam. He is my patient and it is going to stay that way."

"Doctor Novak… I am sure you have done the best that you could within the means you've been given. A generalized hospital such as this… cannot possibly offer the same quality of treatments and attention that Hopkins can give Mr. Winchester. From his charts… he hasn't had very much progress over the years, and it's been quite a few."

"He's not an adult yet, Doctor Burnett and I will not release him from my care. I'm sorry but if you had a thorough look through Sam's file, you would see that in the most recent month he has been making progress and I intend to see that through."

Silence again and Sam could hear the beating of his heart echoing through his head.

"Doctor Novak… One month is nothing. That is nothing against you… I assure you I am not trying to question your abilities or competencies—"

"Good, then I think we're done here."

"Sam would benefit from-"

"He really, truly wouldn't. I don't believe Sam is schizophrenic and I highly doubt that admitting him into a program, that will not take the time to assess him or his needs, would be beneficial to no one other than your own pocket, Doctor Burnett."

"He is a ward of the state, Doctor Novak, and fortunately a small town medical doctor, such as yourself, will probably have a hard time convincing any judge that you deserve and should retain medical privilege over this situation. After all, wasn't it while he was in you care that the young man attacked a staff member, another patient, and tried to commit suicide?"

"I think we're done here."

"Oh, I believe we're just getting started. Good afternoon, Doctor Novak. It's been a pleasure."

Silence. Sam once again was left to focus on his breathing, the beating of his heart. _Thump, thump_. In and out. In and out. _Thump, thump_. In and out.

"I can't help you, Sam." Castiel's voice broke the silence and Sam's heartbeat suddenly spoke up as he registered the words. "I can't help you this way… I have no power here, Sam. None. I need you to wake up, Sam, I need you to move and talk and eat. I need you to help me help you."

 _Thump, thump, thumpthumpthump._

"They're going to take you, Sam. They're going to take you out of here to some fancy hospital and you're going to be pumped full of more drugs than you could ever possibly name. And you don't deserve that, Sam, I know you don't."

Sam felt his skin prickle, a hand suddenly sliding into his own, a thumb rubbing small circles over the back of it. _Thumpthumpthumpthump_. Sam wanted to wake up.

"Please, Sam, please let me help you." Cas' voice was soft, breaking and cracking on the words and Sam felt his own interior cracking as well. He needed to wake up, he needed to open his eyes. Cas was asking him to, begging him to, and Sam not only needed to listen, he wanted to.

"I can help you, I know that I can. But you have to help yourself. No more of this crap… You can't be hurting yourself and shutting down… You're making it easy for them, Sam. Easy for them to write you off as crazy and you're not. I know that you're not… Please, Sam…"

Castiel sat beside him, thumb still rubbing in small circles, the presence both calming and frustrating at the same time. Sam couldn't concentrate on his breathing anymore, only the warm, gentle circles that were being ghosted over his skin. When Castiel slipped his hand out of Sam's and left to go home for the day, Sam could still feel his skin and the soft pressure of the circles.

Sam didn't know why Castiel would believe in him, why anyone would. Sam, himself, didn't believe he was anything but crazy. Maybe once, when he had first gotten to the hospital, he had thought they were the crazy ones. But now…

It was Sam's fault that Dean was dead. That their mother was killed with him. Sam should've been good, should've listened to Dean. He had promised. Promised he would wait until Dean was old enough, promised he would listen and be good for their father. It was his stupid mistake, his stupid, stupid impatience and ignorance that had ripped their world apart and brought out the demon.

And his entire family was dead and gone because of it.

 _"You're a worthless piece of shit, Sam. Do you hear me? You are the reason they're dead. Dean died trying to protect you. Screamed and begged for your safety while he died; your name was the last thing on his lips. How does that make you feel, Sam? Knowing your brother died for you, when you were the one that started all of this in the first place? I wonder if you'll scream for Dean while I rip you apart…"_

Sam opened his eyes and screamed.


End file.
